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Most people with CF have problems absorbing fat-soluble vitamins (A, D, E, and K). This happens because the digestive system doesn't get enough of the pancreatic enzymes it needs to absorb fat or fat-soluble nutrients. Since vitamins are needed to keep your body healthy, your CF care team may prescribe specialty vitamins that have higher concentrations of vitamins A, D, E, and K to help you get the nutrients you need to grow and thrive.1,2

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Vitamins2

Here's the role each vitamin plays in the body:

Vitamin A helps with vision, cell function, and in forming bones and teeth. It also helps protect the body from infection and keeps intestines healthy.

Vitamin D helps build and maintain strong bones and teeth. Vitamin D is important for the body's use of calcium. Bones can become too thin and weak without enough vitamin D.

Vitamin E is an antioxidant. It protects compounds in the body from combining with oxygen. When compounds combine with oxygen, they become harmful to the body. Vitamin E also helps keep red blood cells and intestines healthy. It helps fight infection.

Vitamin K helps blood clot. It also helps keep bones healthy.

These vitamins can be found in certain foods.

Foods rich in vitamins A, D, E, and K3-9

Vitamin A Vitamin D
  • Sweet potatoes
  • Carrots
  • Dark leafy greens (kale, spinach, collards, Swiss chard, etc)
  • Squash (butternut, pumpkin, etc)
  • Dried apricots
  • Cantaloupe
  • Sweet red peppers
  • Tuna fish
  • Mango
  • Peas
  • Tomatoes
  • Peaches
  • Papaya
  • Fresh fish (tuna, mackerel, salmon, etc)
  • Canned fish (tuna, salmon, etc)
  • Fortified cereals
  • Salami
  • Ham
  • Sausage
  • Whole milk (fortified with vitamin D)
  • Cheese (Swiss, goat, ricotta, etc)
  • Eggs
  • Mushrooms (shiitake, portobello, etc)
  • Orange juice (fortified with vitamin D)
  • Oatmeal (fortified with vitamin D)
  • Pork tenderloin
Vitamin E Vitamin K
  • Nuts (almonds, pistachios, pecans, walnuts, etc)
  • Seeds (sunflower, sesame, pumpkin, etc)
  • Avocado
  • Shrimp
  • Plant oils (olive, canola, corn, etc)
  • Squash (butternut, pumpkin, etc)
  • Broccoli
  • Dark leafy greens (kale, spinach, turnip greens, mustard greens, etc)
  • Herbs (dried and fresh)
  • Dark leafy greens (kale, collards, spinach, mustard greens, etc)
  • Brussels sprouts
  • Broccoli
  • Green onion (scallions)
  • Asparagus
  • Cabbage (raw or cooked)
  • Pickles
  • Prunes

Add foods high in fat-soluble vitamins into your diet. Eat these foods in addition to vitamins that your dietitian may suggest.

Supplements10

People with CF sometimes need high-calorie nutritional supplements to maintain a healthy body weight. Supplements (such as SCANDISHAKE®) can be mixed into many foods and beverages, or can come pre-made (such as BOOST® VHC beverage). Supplements can be taken as a snack in between meals or after dinner. Supplements should never replace a meal. This will add to your total daily calorie intake. Before taking supplements, talk to your dietitian about which supplements are right for you. The type and amount differ for each person.

Why nutrition and healthy eating are important11,12

A high-calorie, high-fat diet is a cornerstone of therapy for people with CF. Just because the diet needs to be high in calories and fat doesn't mean it has to be unhealthy. Eat healthy, nutritious meals that include lots of salt, fat, and protein to give the body what it needs to grow and live well. Normal gains in weight and height can help build strong lungs and preserve lung function. In addition, a nutritious diet may also help build up the immune system so it can fight infections.

There are many healthy, high-calorie food options available, whether you're eating at home or dining out.

Did you know that people with CF need to eat 20% to 50% more calories than people without CF?11
Patient Introductions, Infants & Children
Diet and Nutrition, Infants & Children
References: 1. Carr S, McBratney J. The role of vitamins in cystic fibrosis. J R Soc Med. 2000;93(suppl 38):14-19. 2. The importance of vitamins and minerals in CF. Cystic Fibrosis Foundation website. http://www.cff.org/LivingWithCF/StayingHealthy/Diet/Vitamins/. Accessed May 1, 2016. 3. Vitamins A, D, E, and K—what do they do and why are they important? Foundation Care website. http://www.foundcare.com/vitamins-a-d-e-and-k-what-do-they-do-and-why-are-they-important/. Accessed May 1, 2016. 4. Top 10 foods highest in vitamin A. HealthAliciousNess.com website. http://www.healthaliciousness.com/articles/food-sources-of-vitamin-A.php. Accessed May 1, 2016. 5. 26 foods high in vitamin A for healthy eyes. Bembu website. http://bembu.com/vitamin-a-foods. Accessed May 1, 2016. 6. Top 10 foods highest in vitamin D. HealthAliciousNess.com website. http://www.healthaliciousness.com/articles/high-vitamin-D-foods.php. Accessed May 1, 2016. 7. 35 foods high in vitamin D to keep you healthy & young. Bembu website. http://bembu.com/vitamin-d-rich-foods. Accessed May 1, 2016. 8. Top 10 foods highest in vitamin E you can't miss. HealthAliciousNess.com website. http://www.healthaliciousness.com/articles/vitamin-E.php. Accessed May 1, 2016 9. Top 10 foods highest in vitamin K. HealthAliciousNess.com website. http://www.healthaliciousness.com/articles/food-sources-of-vitamin-k.php. Accessed May 1, 2016. 10. Dietary supplements. Cystic Fibrosis Medicine website. http://www.cfmedicine.com/htmldocs/CFText/dietarysupplements.htm. Accessed May 1, 2016. 11. Cystic fibrosis: nutritional considerations. Health care providers' section. NutritionMD website. http://www.nutritionmd.org/health_care_providers/respiratory/cystic_fibrosis_nutrition.html. May 1, 2016. 12. Nutrition for teens with cystic fibrosis. Cystic Fibrosis Foundation website. https://www.cff.org/PDF-Archive/Nutrition-for-Teens/. Accessed May 1, 2016.

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